Development of an evidence-based decision aid on complementary and alternative medicine (CAM) and pain for parents of children with cancer

Miek C Jong,Marianne C Naafs,Gertjan J L Kaspers,Martine Busch,Wim J E Tissing,Inge Boers,Herman Van Wietmarschen

doi:10.1007/s00520-019-05058-8

Abstract

PurposeTo develop an evidence-based decision aid for parents of children with cancer and to help guide them in the use of complementary and alternative medicine (CAM) for cancer care.MethodsThis study had a mixed research design. The needs of parents were investigated by survey and focus group. A systematic review and meta-analysis were performed on the effectiveness of CAM using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Clinical experts were interviewed and a decision aid on CAM treatment for pain was developed.ResultsParents emphasized the importance of reliable information on CAM, focusing primarily on communication and a broad spectrum of complaints related to cancer treatment. The decision aid on CAM for pain included five modalities based on 11 randomized control trials (RCTs): hypnotherapy, mind-body techniques, massage, healing touch, and music therapy. Meta-analysis could be performed on hypnotherapy, which significantly reduced cancer-related procedural pain compared with standard care (MD, − 1.37; 95% CI, − 1.60, − 1.15; P < 0.00001) and attention control (MD, − 1.13; 95% CI, − 1.34, − 0.94; P < 0.00001), and massage, demonstrating no effect on pain compared with standard care (MD, − 0.77; 95% CI, − 1.82, 0.28; P = 0.15). Research evidence and supplementary information from clinical practice and patient were incorporated in a website-based decision aid.ConclusionsAn evidence-based decision aid was developed to support parents of children with cancer in making decisions about CAM for pain management. Next steps will be to expand the website to include additional childhood cancer-related complaints and to evaluate its use in practice.

Highlights

Complementary and alternative medicine (CAM) can be defined as healthcare approaches that are not typically part of conventional medical care or that may have origins outside of usual Western practice [1]
This study describes the process and outcome of a project that aimed to develop and implement an evidence-based decision aid on CAM use for pain in order to enable parents of children with cancer to make well-informed decisions concerning CAM
In order to develop a practical and useful decision aid on CAM use that is likely to be adopted by families affected by cancer, the project started with investigation of the needs of the parents

Summary

Introduction

Complementary and alternative medicine (CAM) can be defined as healthcare approaches that are not typically part of conventional medical care or that may have origins outside of usual Western practice [1]. Not part of mainstream medicine, an increasing number of children with cancer use CAM along with conventional therapies [2]. Parents choose CAM for treatment and cure of cancer in their children [3], and as supportive care agent to help minimize side effects of cancer treatment and to improve the general quality of life and well-being [4, 5]. Despite the high prevalence of CAM use in children with cancer, it is difficult for parents to find reliable information about it. Authoritative and reliable access to information is needed to support parents in their search for information on CAM modalities as potential supportive treatment options for their children with cancer

Methods

Results

Conclusion